The goal of this prospective educational cross-over study is to compare the competency and self-reported confidence in managing acute medical emergencies in fourth year dental students at the Academic Centre for Dentistry (ACTA) after training with a Virtual Reality (VR) training tool. The main questions it aims to answer are: * Do students who were trained with the VR tool perform better or equally good as students who were trained with a traditional training, in managing acute medical emergencies? * Do students who were trained with the VR tool score higher in self-reported confidence scores? Researchers will compare the group who trained with the VR tool with a group who received a traditional training with a mannikin to see if students from one of these methods performs better at a clinical exam in managing an acute emergency that is played by a trained actor. They will also be compared with themselves, since after 4 weeks the groups will be crossed-over and will receive the other training with different clinical scenarios. Half of the participants will * In week 1-4: * Play a VR scenario and watch peer students play other VR scenario's * Fill out a written peer-feedback form and discuss this with peers * Fill out 3 short online questionnairs, before the training, just before the formative clinical exam and just after the formative clinical exam * Participate in a formative clinical exam with a trained actor * In week 5-8: * Play a scenario with a mannikin and watch peer students play other scenario's\* * Fill out a written peer-feedback form and discuss this with peers * Fill out 2 short online questionnairs, just before the summative clinical exam and just after the summative clinical exam * Participate in a summative clinical exam with a trained actor\* The other half of the participants will participate in the same protocol, but in the reverse order. They start with the traditional training with a mannikin in week 1-4 and cross-over to VR in week 5-8. * The training program with a mannikin and the summative clinical exam is part of the regular curriculum.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
OTHER
Masking
NONE
Enrollment
140
Students are immersed in a virtual dental clinic. They see a virtual patient in the dental chair (avatar). The avatar can be controlled by the teacher to show signs of acute medical emergencies. The student can talk to the avatar, the avatar can talk back. The student can use virtual tools, such as blood pressure device, oximeter, etc. to diagnose the emergency and can apply virtual medication such as epinephrine injection, oxigen, etc. They can play 7 different scenario's: fainting, asthma attack, anaphylaxis, stroke, heart attack, epilepsy, hypoglycemia. They can call 911/112 to ask for an ambulance and can do a medical handover to the ambulance personell.
Students are told by the teacher that the mannikin is a dental patient that experiences an acute medical emergency, and what the patients' complaints are. The students can use diagnostic devices, such as blood pressure tool and oximeter, to practice. The teacher tells what the outcome of measurement is and the student proposes a diagnosis and treatment plan. They can give the mannikin test medication such as epinehrin or oxigen.
Academic Center for Dentistry Amsterdam
Amsterdam, North Holland, Netherlands
Competence in diagnosing and treating acute medical emergencies in the dental practice
In week 4 the students will do a formative clinical test with a trained actor, who plays an acute medical emergency scenario. The topic of the scenario will be randomly assigned by drawing a lot. The students will be scored using a validated scoring table, that measures all the necessary steps in the DRS ABCDE protocol. They can obtain a maximum score of 80 when they do all the necessary steps to manage the acute emergency. Again in week 8 the students will do a summative clinical test with a trained actor. The topic of the scenario be randomly assigned. The students will be scored using the same validated scoring table. They will pass the test if they used the adequate diagnostic tools, made the correct diagnosis and communicated effectively with the ambulance personnel. The point score on the scoring table will only be used for research purposes.
Time frame: From enrollment assessment takes place in Week 4 and week 8
Self-reported competence in managing acute medical emergencies
Students will be asked to fill out 5 online surveys to report on their experienced sense of competence. The questions will be on a 5 point likert scale. T=0: before enrolling in the training T=1: just before the formative clinical test in week 4 T=2: just after the formative clinical test in week 4 T=3: just before the summative clinical test in week 8 T=4: just after the summative clinical test in week 8
Time frame: From enrollment until week 4 and 8
Self-reported confidence in managing acute medical emergencies
Students will be asked to fill out 5 online surveys to report on their experienced sense of confidence. The questions will be on a 5 point likert scale. T=0: before enrolling in the training T=1: just before the formative clinical test in week 4 T=2: just after the formative clinical test in week 4 T=3: just before the summative clinical test in week 8 T=4: just after the summative clinical test in week 8
Time frame: From enrollment in week 4 and 8
Effects of order and carry-over effects in the cross-over design
To assess whether the order in which participants receive the virtual reality training and the comparator training affects outcome scores, and whether exposure to the first intervention has a residual effect on outcomes measured after the second intervention. Intervention sequence (VR-first versus comparator-first), study period, and prior intervention exposure will be evaluated in a mixed-effects model, accounting for repeated measurements within participants.
Time frame: From enrollment until week 8
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